| NPI | 1457523227 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 133V00000X Dietitian, Registered (Licence: FL ND4956) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: FL ND4956) |
| Enumeration Date | 2008-04-01 |
| Last Update Date | 2008-04-01 |